Key result
Early invasive approaches and reperfusion therapies are safe and significantly reduce mortality in elderly patients with acute myocardial infarction, though these treatments remain underutilized in this population.
Why the study?
Older patients with acute myocardial infarction are underrepresented in clinical trials, and literature on their pharmacological and endovascular treatment contains fragmented and contradictory data.
Despite higher risks of complications and underrepresentation in trials, elderly patients with acute myocardial infarction benefit significantly from evidence-based pharmacological and interventional treatments, warranting careful but active management.
May support greater use of early reperfusion in elderly AMI despite underutilization; leaves open need for dedicated RCTs to guide selection.
Acute myocardial infarction is one of the most socially important diseases with a high rate of mortality and disability. Cardiovascular heart disease represents the leading cause of death in people those over 65 years. In elderly and old patients atypical forms of myocardial infarction are common. High rate of comorbidities, functional and socioeconomic status, side effects associated with drug administration create difficulty in the diagnosis and selection of treatment in the elderly. These patients need a prolonged monitoring with using an additional examinations and dynamic observation. Compared to younger subjects, elderly patients with acute myocardial infarction are less likely to receive evidence-based treatment, including myocardial revascularization therapy. Endovascular revascularization is currently the main standard for the treatment of acute myocardial infarction, but the advantage of the use of interventional cardiology techniques in elderly patients has been insufficiently studied. Older patients are generally underrepresented in cardiovascular trials. Modern scientific literature, illuminating issues of application of pharmacological and endovascular treatment of acute myocardial infarction in elderly and old age patients, contains fragmented and, in some cases, contradictory data. The authors have taken an attempt to systemize current information in this field based on recommendations, major studies and meta-analyses.
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Козлов et al. (2020) conducted a review in Acute myocardial infarction. Reperfusion therapy and percutaneous coronary intervention vs. Conservative management was evaluated. Early invasive approaches and reperfusion therapies are safe and significantly reduce mortality in elderly patients with acute myocardial infarction, though these treatments remain underutilized in this population.
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